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Monday, September 18, 2006

AIDS affects children too, or have we forgotten that?

This editorial appeared in the San Jose Mercury News last week.

Posted on Thu, Sep. 14, 2006

AIDS affects children too, or have we forgotten that?

By Ruthann Richter

In all the bluster of the recent International AIDS Conference in Toronto, where did the children go? It was stunning how little attention was paid to them, with hardly a mention of children in all the talk about how to contain the epidemic and treat those in need.

The epidemic is 25 years old, yet we are still at a stage where children are largely ignored in the policy arena and receive minimal funding to meet their needs, both physical and psychological. That is the case despite that 2.3 million of the world's children -- most of them in sub-Saharan Africa -- are now living and dying with HIV. And an additional 15 million are growing up without the nurturing hand of a mother or father because AIDS has taken them away.

``It is impossible to understand how, in the year 2006, we continue to fail to implement policies to address the torrent, the deluge, of orphan children,'' Stephen Lewis, the U.N. envoy for AIDS in Africa, said in closing the mammoth conference Aug. 18. ``I appeal to everyone to recognize that we're walking on the knife's edge of an unsolvable human catastrophe.''

While the number of orphans is escalating, only 3 to 5 percent of them receive any help from government programs, a figure Lewis called ``chilling.'' And though young children are particularly susceptible to the ravages of HIV, with 60 to 70 percent dying by their fifth birthday, fewer than 5 percent of those infected benefit from treatment.

The Clinton Foundation certainly must be credited for advancing the cause of children, helping bring down the cost of pediatric antiretrovirals to less than $200 a year and making these lifesaving drugs available to more than 10,000 children. But as Clinton himself acknowledged at the conference, it's a small fraction of the more than 500,000 youngsters with advanced disease who desperately need treatment to live.

Children continue to be discriminated against on many fronts. Kenyan pediatrician Ruth Nduati, the only plenary conference speaker who focused on children's issues, observed that while adults get free testing for HIV in Kenya, children have to pay a fee -- hardly an option for youngsters often living on the edge of starvation. And while there are 280 sites in the East African country that now hand out anti-AIDS drugs, only 76 of them offer them to children.

During my travels in Kenya, I visited a number of projects to help youngsters -- small, grass-roots programs run by local activists who have rushed in to fill the gap. These programs operate on shoestring budgets, without the benefit of aid from governments or global organizations, which have been woefully absent from the movement to care for orphans and vulnerable children.

Some programs, like the Mji Wa Neema (House of Hope) orphanage in Naivasha, are run by faith-based organizations, in this case the local Catholic Church. The parish priest, Father Daniel Kiriti, has been recast in the role of HIV activist, for he sees the orphans literally collecting at his doorstep. One child, only hours old, arrived early one Sunday morning -- a small package in a paper bag borne by a parishioner who had rescued her from the parish fence. Tolea, as she is called, is now thriving at the orphanage despite infection with HIV.

At another project in Gilgil, a retired nurse and a local cafe owner have cobbled together a home of last resort for children who have no other place to go. One resident, 2-year-old Mary Maishon, was within weeks of starving to death when they rescued her last year. Both her parents had died of AIDS, and her grandfather had virtually abandoned her. She had been living under a piece of cardboard and plastic with her 4-year-old sister and 3-year-old cousin. Mary had been crippled by malnutrition, unable to walk, and too traumatized to talk. She is alive today only because of the efforts of a few community activists working with scarce, donated funds.

It's unforgivable that the world continues to turn its back on children like Mary and Tolea. Saving the younger generation is not only the right thing -- the human thing -- to do, but it is also important for global security and stability. As Lewis warned, if we don't intervene now, ``We are inviting the whirlwind, and we will not be able to cope.''RUTHANN RICHTER, director of media relations at the Stanford University School of Medicine, writes frequently on the topic of children and AIDS. She wrote this article for the Mercury News.

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